Academic journal article Advances in Mental Health

When Your Parent Has a Mental Illness: Children's Experiences of a Psycho-Educational Intervention

Academic journal article Advances in Mental Health

When Your Parent Has a Mental Illness: Children's Experiences of a Psycho-Educational Intervention

Article excerpt

Introduction

Young people living in families where a parent has a mental illness are at higher risk of acquiring social, emotional and behavioural difficulties, compared to their peers (Leschied, Chiodo, Whitehead, & Hurley, 2005). At the same time, not all children will be adversely impacted by parental mental illness, nor will all children in the same family be affected in the same manner (Reupert, Maybery, & Kowalenko, 2012). Children vary in their ability to cope with their environment. Some children can cope well (Sheehan, 1997), and have the opportunity to access functional social supports (Edwards, Eiden, & Leonard, 2006), while others appear to cope less well (Mordoch & Hall, 2008). This pilot study explores the utility of a psycho-educational tool for these children, as a preliminary way of establishing some of the issues that may be involved in a full-scale evaluation study.

There is much that can be done to prevent the intergenerational transmission of mental illness in families. Siegenthaler, Munder, and Egger (2012) systematically reviewed 13 randomised controlled trial studies of interventions for families with parents who have a mental illness. They found that interventions, which commonly include cognitive, behavioural and psychoeducational components, have the potential to decrease children's internalising behaviours and reduce the likelihood of young people acquiring their own mental illness by 40%. There are also additional interventions which target other impacts of living in a family where a parent has a mental illness such as family breakdown (Oram, Trevillion, Feder, & Howard, 2013), substance abuse problems (Reupert, Goodyear, & Maybery, 2012) and socio-economic disadvantage (Eaton, Muntaner, & Sapag, 2010; Murali & Oyebode, 2004).

Notwithstanding the importance of these potential environmental targets for children in families where parents have mental illness, the interventions commonly offered to young people include peer support programmes, online supports and psycho-educational materials such as DVDs or books, each with varying levels of success (Reupert, Cuff, et al., 2012). A common component across these interventions is the provision of information or psychoeducation to children about their parent's mental illness (Reupert, Maybery, et al., 2012). Lukens and McFarlane (2004)define psycho-education as psycho-therapeutic and educational information designed to support and empower individuals through a strength-based approach. Psycho-education typically presents biomedical information on the causes, symptoms and treatment of mental illness; it may also incorporate ways that individuals learn to adaptively cope with a mental illness (Lukens & McFarlane, 2004). However, psycho-education activities in reference to children whose parents have a mental illness take on a relatively more nuanced stance by emphasising the importance of talking with, rather than to young people. This means that psycho-educational discussions for this target group of youth are normally interactive and child-led. For example, Reupert and Maybery (2010) describe the manner in which support group facilitators deliver psycho-education through groups or one-to-one discussion, with consideration of the young person's family context and the questions and concerns he or she might have. Gladstone, Boydell, Seeman, and McKeever (2011) concur with these findings when they argue that psycho-education needs to commence with, and incorporate the child's perspective of, their parent's illness.

Alasuutari and Jarvi (2012) propose that children's understanding of their parent's illness is always developing and evolving over time. They argue that young people have prior knowledge or understanding of what is happening for their parent and that this needs to be acknowledged in any given intervention. Accordingly, each child will understand and want information differently; indeed, some may not want any or certain kinds of information about their parent's illness (Gladstone, McKeever, Seeman, & Boydell, 2014). …

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